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Biomedical subjects

F J van Leerdam

Publications and source records attributed to F J van Leerdam.

9 recordsLinked to original sources
PubMed2004

[Further development of 'Enuresis nocturna' guidelines for children with persistent problems].

To achieve dryness in children who suffer from persistent bedwetting, it is important to find out which factors play a role in their bedwetting and why previous treatment has failed. The use of a micturition diary is essential. The child's problems and needs have to be identified and treated individually. The enuresis alarm, with the proper guidance, is the preferred form of initial treatment. Desmopressin is particularly suitable in cases of nocturnal polyuria or if the use of the alarm is unfeasible. If the alarm does not have any effect within two weeks or if a rapid result is important, a combination of desmopressin and the alarm is advisable. Bedwetting combined with daytime micturition problems is often indicative of a small bladder capacity and/or detrusor instability. In these children bladder training and/or treatment with an anticholinergic drug (possibly combined with desmopressin) may be effective.

Behavior Therapy↗
PubMed2003

[The guideline 'Detection of visual disorders at the age of 0-19' from the Dutch Association of Child Health Care].

The child health-care guideline 'Detection of visual disorders at the age of 0-19' draws attention to the importance of early detection of visual disorders and provides guidelines to child health-care workers for detecting disorders during routine check-ups. Children under the age of 3 are examined by the 'Early detection of visual disorders' method. Picture charts may be used for children from the age 3 onwards. From the age of 3.5 charts which follow the Snellen principle such as the Landolt-C chart should be used. Screening for refraction after the age of 7 and screening for colour blindness are not necessary. Children born before 32 weeks of pregnancy, children with a family history of visual disorders and mentally disabled children have an increased risk of visual disorders.

Adolescent↗
PubMed2000

[Youth Health Care Services guideline 'Early screening for hearing impairment, 0-19 years'].

The Youth Health Care guideline 'Early screening for hearing impairment, ages 0-19 years' draws the attention of all parties involved to the case finding of, notably, perceptive hearing loss; it helps workers in the Youth Health Care argue their referrals and improve the next steps in the process. Referrals always aim at ruling out perceptive hearing impairment. It is essential to diagnose and subsequently treat children with perceptive hearing impairment. It is important to keep track of the process after the referral. Screening methods are the Ewing test, the 'Compacte Amsterdamse paedo-audiometrische screener' (CAPAS) test and audiograms. Each age category has groups at risk for hearing impairment. Problems in neonates are a low specificity of the Ewing/CAPAS tests, treatment of middle ear disease without ruling out perceptive hearing impairment and absence of interdisciplinary agreements regarding the steps to be taken and the necessary feedback. Children with perceptive hearing loss should be diagnosed before 18 months of age. In the near future neonatal screening may detect congenital perceptive hearing impairment, but hearing impairment may still develop after the screening. Alertness with respect to hearing impairment will remain necessary in every consultation of a child.

Adolescent↗
PubMed1998

[Alarm training also successful in 5 to 7 year olds with nocturnal enuresis].

OBJECTIVE: To determine how many bed-wetting children aged 5-7 years unlearn the habit using the alarm treatment. DESIGN: Descriptive. SETTING: TNO Prevention and Health, Leiden, the Netherlands. METHODS: The population consisted of all children aged 5 to 7 with nocturnal enuresis (defined as > or = 2 wettings per week) who ordered an Elther alarm set (Elther BV, Tilburg) in May or June 1996 (n = III). The parents and the child were asked to keep notes during the treatment of whether the child had remained dry and of whether the alarm had sounded. When at the time of cessation of the alarm training the results were insufficient, the parents were asked about the reason to stop. When the child had remained dry for 14 nights in succession (the definition of 'success'), a questionnaire was sent 6 months later to inquire if the child was still dry or had relapsed. RESULTS: The totals of success for children aged 5, 6 and 7 years were 70% (n = 7/10), 73% (n = 29/40) and 90% (n = 55/61), respectively. Seven-year-olds were significantly more successful than the children aged 5 or 6 (p = 0.02). No significant correlations were found between results of treatment and sex, the nature of the enuresis (purely functional or not), familial occurrence and frequency of bed-wetting at the start of the treatment. The average times until success were 53 days for the 5-year-olds (range: 31-78), 65 days for the 6-year-olds (26-154) and 59 for the 7-year-olds (17-141). The proportions of relapse after 6 months were 0%, 14% and 9%, respectively. CONCLUSION: Alarm training with pad and buzzer appears to be a suitable method of treatment even for children younger than 8 years.

Age Factors↗
PubMed1997

Bedwetting and behavioural and/or emotional problems.

OBJECTIVE: To assess the link between enuresis nocturna and the severity of behavioural and/or emotional problems in Dutch children and the course of these problems. SETTING: West-Mine Region in the Netherlands. SUBJECTS AND METHODS: Prospective cohort study involving 66 of the 80 bedwetting children from all 1652 children born in 1983 in this region. After 1 y, contact was still possible with 64 of the enuretics. We used the Dutch version of the Child Behaviour Checklist (CBCL) and a questionnaire about bedwetting. RESULTS: The mean T-score for Total Problems (CBCL score) in 1992 (M1; mean age 8.6) was 52.1, and 1 y later was 49.2 (M2). There was no significant difference in the CBCL scores for M1, M2 and a matching group from the Dutch CBCL norm population, either in the group who remained wet or in the group who became dry. There were no differences between the sexes. There was no link between the severity of behavioural and emotional problems and the frequency of bedwetting. However, more children with bedwetting than expected were in the clinical range. CONCLUSION: There was no difference in behavioural and/or emotional problems between the first and the second measurement and the matching group from the CBCL norm group. There were no differences in behavioural and/or emotional problems between primary and secondary bedwetters, nor were there any consequences related to the frequency of bedwetting.

Affective Symptoms↗
PubMed1997

Enuresis nocturna in adults.

To assess the prevalence and characteristics of enuresis nocturna in adults, the treatment they received and the perceived impact, a random sample of 13081 non-institutionalized adults (18-64 years old) were asked to participate in the study in January-March 1996. The response rate was 87%. A personal computer questionnaire included 23 questions on frequency of bedwetting, daytime wetting, treatment and perceived impact. Any respondent reporting bedwetting at least once during the previous 4 weeks was considered to have enuresis nocturna. The overall prevalence of enuresis nocturna was 0.5%. Differences between age groups and sexes were not significant. Fifty percent of men and 19% of women reporting enuresis nocturna had primary enuresis nocturna, of those with enuresis nocturna, 12% of men and 29% of women had always daytime incontinence. Fifty percent of the men and 35% of the women had never consulted a care provider for their bedwetting and 38% of the men and 26% of the women had done nothing to become dry. Only 30% believed that bedwetting was treatable. Bedwetting was associated with several psychosocial problems. Enuresis nocturna in adults is common and may lead to embarrassment and discomfort. It may affect careers, social life and personal relationships. Adults should be more aware that bedwetting is a treatable problem. More information should be given on this issue.

Adolescent↗